Cuchel — Trientine 250 mg (100 Capsules)

Cuchel (Trientine) is prescribed for the therapy of the following conditions:

• 🔹 Wilson-Konovalov Disease: Treatment of adults and children with excessive copper accumulation in the body, especially in cases of intolerance or ineffectiveness of D-penicillamine therapy.
• 🔹 Maintenance Therapy: Long-term copper level control in patients who have reached clinical stabilization.

Sales Form: 1 pack contains 100 capsules of 250 mg.

⚠️ INSTRUCTIONS FOR USE:

• Dosage Regimen: The dosage is selected individually by a physician based on copper levels in blood and urine. The usual starting dose for adults is 750–1250 mg per day, divided into 2–4 intakes.
• Method: Capsules should be taken on an empty stomach: at least 1 hour before meals or 2 hours after meals. The capsule must be swallowed whole, without chewing or opening.
• Important Condition: The interval between taking Cuchel and iron supplements or antacids should be at least 2 hours, as they reduce each other's effectiveness.
• Storage: Store in a tightly closed container. Refrigeration (2°C to 8°C) is recommended to maintain the stability of the active substance.

• ⛔ Hypersensitivity: Individual intolerance to trientine or any inactive component of the drug.
• ⛔ Cystinuria and Rheumatoid Arthritis: Unlike penicillamine, trientine is not indicated for the treatment of these conditions.
• ⛔ Pregnancy and Lactation: Use is possible only in cases where the expected benefit to the mother outweighs the potential risk to the fetus (under strict medical supervision).
• ⛔ Acute Conditions: Not recommended for use as monotherapy in decompensated liver failure.

The drug is generally better tolerated than penicillamine; however, the following side effects may be observed:

• 🩸 Hematopoiesis: Risk of developing iron-deficiency anemia (trientine can interfere with the absorption of iron from food).
• 🤢 Digestion: Heartburn, stomach pain, nausea, colitis.
• 🧪 Skin Reactions: Skin rash, itching, or dermatitis (occur rarely).
• 🧠 Neurology: At the beginning of therapy, a temporary worsening of neurological symptoms is possible due to the sudden release of copper from tissues into the bloodstream.
• ⚠️ Important: During treatment, it is necessary to regularly test serum iron levels and monitor daily urinary copper excretion.